Creativity of People with Parkinson’s Enhanced with Dopamine Therapy
As she continues to pursue her fascination with the creative process of her Parkinson’s patients treated with dopamine replacement therapies, Dr. Rivka Inzelberg has just published a new paper in the Annals of Neurology journal. Dr. Inzelberg is associated with the Department of Neurology at the Sheba Medical Center and the Sackler Faculty of Medicine at Tel Aviv University in Israel. Several years ago, she noticed that at holiday time, when patients brought her small gifts, the gifts were no longer of the chocolates and wine, but small artistic creations produced by the patients themselves.
Her research lead her to the connection between dopamine and behavior and its involvement with the “reward system”. It is also associated with impulse control disorders (ICD) and stories of how dopamine replacement therapies have triggered destructive bouts of gambling or unrestrained shopping sprees abound. But there is also a creative impulse in some patients that has been discovered or enhanced by this therapy. And this artistic creativity spans all creative genres, from painting and drawing, to writing poetry and more. Dr. Inzelberg speculated that perhaps the loosening of the impulse control helps patients to find the courage to express their talents or helps them express their talents in different ways, but her creative patients did not all fit the impulse control model. So she designed a study “to identify features of creative thinking in PD patients and examine whether creativity in PD patients treated with dopaminergic therapy is an expression of ICD or a distinct phenomenon.”
Together with her research team, they recruited 27 Parkinson’s patients and 27 healthy, age matched controls. Both groups met certain education requirements, had similar cognitive testing results and were screened to rule out depression. Both groups underwent a battery of testing. Verbal and creativity tests consisted of Verbal Fluency, Remote Association Test, the Tel-Aviv University Creativity Test, and a test of novel metaphors in which they must determine if the meaning of multiple two word expressions is literal, conventional, novel or meaningless. This test in particular requires a semantic flexibility or a creative sensibility as compared to simple meaning retrieval of words already in the vocabulary. Subjects were also given tests to evaluate for any symptoms of Impulse Control Disorder.
The subjects in the Parkinson’s side of the study were then further sub-divided into three groups, based on the amount of levodopa (dopamine replacement) they were receiving, from highest, mid level or lowest. The researchers found a “significantly higher amount of creative responses” among the group with the highest dose of levodopa.
Further analysis of the results showed a significantly enhanced creativity among the Parkinson’s patients compared to the healthy controls. There was also no correlation between creativity and impulse control disorder, which was one of the main questions this study sought to resolve.
The results suggest that the creative process that requires originality and flexibility is supported by a distinct neurological process, and that dopamine is involved in enhancing verbal flexibility and visual creativity. The researchers suggest that the role of dopamine in the creative process may enable the brain to filter out unnecessary or irrelevant stimuli while at the same time improving divergent thinking and creating more associated meanings.
The authors of this study stress that it was done on a small population of Parkinson’s patients who were already receiving dopamine therapy. Further studies could follow subjects from early stages without dopamine replacement to later stages with dopamine replacement and monitor changes in creativity related to dosage changes. They also feel that it is perhaps only a subset of the Parkinson’s population that has a strong creativity process.
The Awakening of Artistic Creativity and Parkinson’s Disease.
Behavioral Neuroscience (Impact Factor: 2.63). 01/2013; DOI:10.1037/a0031052
A Faust-Socher, YN Kenett, OS Cohen, S Hassin-Baer and R Inzelberg
Accepted manuscript online: 10 MAY 2014 03:33AM EST | DOI: 10.1002/ana.24181
Review by Marcia McCall